Sassa Toshiharu, Okamoto Ken, Tazume Hirokazu, Noguchi Ryo, Koga Ayumi, Fukui Toshihiro
Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan.
Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan.
Ann Thorac Surg. 2017 Apr;103(4):e335-e337. doi: 10.1016/j.athoracsur.2016.09.081.
We evaluated a 49-year-old man with severe tricuspid valve regurgitation and coronary artery disease who had undergone congenital ventricular septal defect repair four decades previously. We found an enlarged, prolapsed commissure between the anterior and septal leaflets and a ruptured septal leaflet chorda. Two mattress sutures closed the commissure, with the leaflets' height matched by inverting the prolapsed site ventricularly. After implanting the annuloplasty band, we undertook chordal replacement using expanded polytetrafluoroethylene sutures. Artificial chorda length was determined using a small tourniquet and the saline test. Two coronary artery bypass grafts were also implanted. Postoperative echocardiography demonstrated no tricuspid regurgitation.
